Prediction of relapse within eight weeks after an acute asthma exacerbation in adults.
Associations between historical, presenting, and treatment-related characteristics and relapse within 8 weeks after a moderate to severe asthma exacerbation were studied in a cohort of 284 adult asthmatics. Data were collected prospectively, and a multivariate model was developed and internally validated. Within 10 days, only 8% had relapsed, increasing to 45% by 8 weeks. Three variables that could be identified at the time of discharge were independently associated with relapse. These included: having made three or more visits to an emergency department in the prior 6 months (hazard ratio (HR) = 2.3, 95% CI = 1.6-3.4); difficulty performing work or activities as a result of physical health in the 4 weeks prior (HR = 2.7, 95% CI = 1.6-4.3); discontinuing hospital-based treatment for the exacerbation within 24 hours without having achieved a peak expiratory flow rate of at least 50% of predicted (HR = 2.6, 95% CI = 1.6-4.1). These risk factors may help to identify patients with poorly controlled asthma in need of more intensive and comprehensive management.
McCarren
M
M
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago 60612, USA.
McDermott
M F
MF
Zalenski
R J
RJ
Jovanovic
B
B
Marder
D
D
Murphy
D G
DG
Kampe
L M
LM
Misiewicz
V M
VM
Rydman
R J
RJ
D000208:Acute Disease; D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors